Patients suffering from lower back pain are extremely common in physiotherapy practices and are arguably the most common clinical presentation. It is estimated that approximately 70% of the general population will experience lower back pain at some stage in their lives. Pain is usually caused by local structures within or around the lower back, or may occasionally be referred from other sources (such as the upper back, or abdomen).

Sudden onset lower back pain often occurs in individuals involved with heavy lifting, bending or twisting activities, or combinations of these movements. It is also relatively common for patients to experience sudden onset lower back pain during a trivial bending movement, such as picking up a pencil or even when sneezing. These acute injuries usually involve tearing of connective tissues around the joints of the lower back and often have associated muscle spasm. One of the most common causes of sudden onset pain in the lower back, which can also often cause pain to radiate into the buttock, thigh, lower leg, ankle or foot, is a lumbar disc bulge. Lower back pain can also commonly be caused by facet joint sprains.

Gradual onset lower back pain often occurs in those patients involved in repetitive or prolonged bending, lifting, twisting or sitting (especially with a poor posture) or combinations of these activities. One of the most common causes of gradual onset pain in the lower back, with or without pain radiating into the buttock, thigh, lower leg, ankle or foot, is a lumbar disc ulge. In older patients with gradual onset lower back pain, one of the most likely causes of symptoms is degenerative changes in the spine (i.e. spinal degeneration).

There are numerous other causes of lower back pain, some of which present suddenly due to a specific incident and others which develop gradually over time. Below are some of the more common causes of pain in the lower back with a brief description of each condition to aid diagnosis. Conditions have been organised according to sudden or gradual onset and common or less common conditions for ease of use.

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